This is a sub-study of the THEMIS presented during the ESC 2019 scientific sessions in Paris, and simultaneously published in Lancet. They were all diabetics with stable coronary artery disease, but in this sub-study patients also had prior PCI. It included over 11000 patients with prior PCI for whom the combination of ticagrelor and aspirin…
ESC 2019 | THEMIS: Ticagrelor in Diabetics with Stable Coronary Artery Disease
The use of ticagrelor in patients with stable coronary artery disease significantly reduces the rate of major cardiovascular events when compared against aspirin, according to this study presented on Sunday at ESC 2019 simultaneously published in NEJM, though the cost in terms of major bleeding seems unacceptable. Primary end point rate (composite of cardiovascular death,…
Can Antiplatelet Therapy Affect the Life of Coronary Grafts?
The antiplatelet treatment strategy providing optimal balance between thrombotic and bleeding risks in patients undergoing myocardial revascularization surgery is unclear. What does seem somewhat certain is that some antiplatelet therapy is necessary to prevent early thrombosis, mainly in vein grafts, but (as opposed to what happens with angioplasty) there are other relevant factors such as…
ESC 2018 | ASCEND: Aspirin for Primary Prevention in Diabetic Patients Fails the Cost-Benefit Analysis
The obvious risk of bleeding posed by aspirin was too clear in this work, casting a shadow of doubt over the indication of aspirin for primary prevention in diabetic patients. According to the ASCEND trial, presented at the European Society of Cardiology (ESC) 2018 Congress and simultaneously published in NEJM, aspirin reduces cardiovascular events as…
ESC 2018 | FRANCE-TAVI: Atrial Fibrillation and Anticoagulation Associated to Mortality in TAVR
Some of the many ongoing randomized studies including patients with atrial fibrillation (AF) might finally answer the question on the best antithrombotic scheme post TAVR. According to this registry, in patients undergoing transcatheter aortic valve replacement, independent predictors of death at 3 years are being a man, having moderate to severe kidney failure, and having…
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